MMWR – Morbidity and Mortality Weekly Report

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1. National, State, and Local Area Vaccination Coverage Among Children Aged 19–35 Months — United States, 2012

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When parents make sure their children stay up-to-date on their vaccines, they can help protect their own children from serious diseases and prevent these diseases from spreading to family members, friends, and throughout their communities.  Immunization of U.S. children aged 19-35 months remains high, with coverage for many routine vaccines remaining near or above 90 percent, according to the 2012 National Immunization Survey (NIS). However, low vaccination rates for measles in some states are a concern, and measles continues to cause outbreaks in communities with susceptible children and adults. Today, CDC reported a higher than normal number of measles cases so far this year in the United States and described recent outbreaks of the disease.  All of the measles cases reported in the United States in 2013 are considered to be associated with importations from other countries, and most U.S. residents who got measles this year were unvaccinated due to philosophical objections to vaccination. The Vaccines for Children Program (VFC) has been critical to achieving and maintaining high immunization rates among U.S. children.  This year marks the 20th anniversary of the passage of the legislation that created the program, which removes financial barriers to vaccination for eligible children, helping to ensure they have access to life-protecting and life-saving vaccines.

2. Measles — United States, January 1–August 24, 2013

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Unvaccinated people place themselves and others in their communities at risk for measles and other vaccine preventable diseases. Measles is a highly contagious viral disease that is preventable by vaccination. In the United States, measles elimination (i.e. absence of year round transmission) was declared in 2000. However, measles continues to be imported into the United States from countries where measles is still common. During January 1– August 24, 2013, 159 measles cases, including 8 outbreaks were reported to CDC. An outbreak in New York City is the largest outbreak reported in the United States since 1996 (58 cases). Most cases were import-associated [157 (99 percent)] and in persons who were unvaccinated [131 (82 percent)] or had unknown vaccination status [15 (9 percent)]. Among U.S. residents who were unvaccinated, 92 (79 percent) have philosophical objection to vaccination. High vaccine coverage is important to prevent spread of measles following importation.

3. Caregiver and Physician Influenza Vaccination Practices for Children with Neurologic and Neurodevelopmental Conditions — United States, 2011–12 Influenza Season

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Children with neurologic and neurodevelopmental conditions can experience flu complications that can be life-threatening.  A yearly flu vaccine can protect children with these conditions in many cases by preventing them from getting sick with the flu.  According to findings of a new CDC study, only about half of children with neurologic or neurodevelopmental conditions are vaccinated against the flu each year. Also, most parents look to their child’s health care provider for information about vaccines, including the flu shot. The study found that some pediatricians do not recognize specific conditions that put children at high risk for flu illness. Children with these conditions are more likely to have complications if they get sick with flu. This new study explains the important role that healthcare providers play in providing health information about flu vaccinations for children with neurologic and neurodevelopmental conditions.

4. Comparison of Provisional with Final Notifiable Disease Case Counts — Nationally Notifiable Diseases Surveillance System, 2009

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Data in the National Notifiable Diseases Surveillance System (NNDSS) are subject to case reclassification, leading to under-or over notification.   The primary appeal of provisional counts is timeliness in comparison with final counts, which are more complete and accurate. Provisional case counts should be interpreted with caution due to the reporting process. The extent to which the weekly notifiable conditions are over- or underreported can affect public health understanding of changes in the burden, distribution, and trends in disease, which is essential for control of communicable diseases. Because provisional data are subject to change, understanding of regional and national disease patterns by public health authorities remains fluid until case investigations are completed and the status of cases is determined. CDC reviewed 2009 NNDSS data for 67 conditions.  For five conditions, final case counts were lower than provisional counts, but for 59 conditions, final counts were higher than provisional counts. Increased knowledge of the differences between provisional and final data can help in guiding the use of information from NNDSS.

5. Notes from the Field

• Measles Outbreak Among Members of a Religious Community — Brooklyn, New York, March–June 2013
• Measles Outbreak Associated with a Traveler Returning from India — North Carolina, April-May 2013

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES